Rhinoplasty surgery can change the shape of your nose and refine your mid-face, enhancing your other features while improving your facial balance and aesthetics. In Pasadena, rhinoplasty is skillfully performed by board-certified plastic surgeon Dr. Andre Panossian, who operates out of his practice near Los Angeles.
- Rhinoplasty Surgery Explained
- Rhinoplasty Before-and-After Pictures
- Variations of Rhinoplasty
- Revision Rhinoplasty
- Revision Rhinoplasty Before-and-After Pictures
- Why Would I Want a Rhinoplasty?
- Am I a Candidate for Rhinoplasty in Pasadena?
- What to Expect at a Rhinoplasty Consultation
- How to Prepare for Rhinoplasty Surgery
- The Rhinoplasty Surgery
- Recovering from a Rhinoplasty
- Post-operative Instructions
- Potential Risks and Side Effects of Rhinoplasty
- Why Should Dr. Panossian Perform My Rhinoplasty?
- Frequently Asked Questions About Rhinoplasty
Rhinoplasty Surgery Explained
In Los Angeles, rhinoplasty is most often known as a “nose job.” This facial plastic surgery is designed to change the projection, size, and shape of the nose for cosmetic or functional purposes. For patients, a nose job can have both physical and emotional benefits.
Because the nose is almost always visible, self-consciousness often begins in adolescence. A prominent nose is typically genetic, and the trait is passed down from one generation to the next. In other cases, the nose may have been altered by trauma or disease.
Rhinoplasty is one of the most transformative procedures in cosmetic medicine, and changes by the millimeter can dramatically improve a person’s looks.
Rhinoplasty Before-and-After Pictures
Patient Example #1: This patient underwent open rhinoplasty to correct a severely deviated nose and septum as well as heavy correction of the dorsal hump and hanging tip. Smiling preop shows excessive tethering of the tip with worsening droop. All deformities were corrected with improvement of breathing due to correction of a severely deviated septum.
Patient Example #2: This patient underwent closed rhinoplasty to straighten the nose, reduce the dorsal hump, and refine the tip. Nasal airway obstruction was also addressed. Swelling in the tip may take 1-2 years to resolve. Check out the rhinoplasty Before and After photo gallery to see additional views of this patient.
Variations of Rhinoplasty
In cases of functional rhinoplasty or septoplasty, a plastic surgeon can correct breathing problems caused by a deviated septum. This occurs when the cartilage and bone that separates the nasal passages is crooked or uneven, leading to decreased air intake and irregular mucus drainage through the affected nostril.
In more severe cases, a deviated septum may affect both nostrils. Deviated septum repair is generally covered by insurance because it is performed to improve the function of the nose. If it is performed alongside cosmetic rhinoplasty, generally only the functional portion of the surgery is covered.
Cleft Lip Rhinoplasty
Cleft lip rhinoplasty is part of a cleft palate repair surgery. The condition is apparent at birth and occurs with the improper formation on the roof of the mouth which can expand to the lip and nose. The nose may be affected by this split and can often be repaired through a nose job surgery.
In some cases, surgery may not be necessary for the doctor to create minor adjustments in the nose. During a non-surgical or liquid rhinoplasty, the doctor can inject dermal fillers under the skin to disguise a hooked nose or dorsal hump, correct most asymmetry, fill in dips, and create a straighter-looking nose.
The doctor may also be able to balance a large nose by adding fillers to the chin, creating more facial harmony from a profile perspective. Fillers are not a permanent solution and must be repeated every year or so to maintain results.
Female rhinoplasty and male rhinoplasty are performed with consideration to a person’s apparent or preferred gender characteristics. A broader nose can appear more masculine while a refined, sleeker look is generally considered feminine. The doctor adjusts his rhinoplasty techniques to create the aesthetic that most appeals to his patients.
During this version of the surgical procedure, the doctor improves the look of the nose but takes special care to ensure that the new nose appears in harmony with the patient’s ethnic identity and facial features. Ethnic rhinoplasty may require more subtle corrections for this reason.
Revision rhinoplasty has unfortunately become a common procedure in the world of plastic surgery. Often, patients are subjected to aggressive or inaccurate nose job procedures which, in many cases, leave them with deformities and breathing problems. Revision rhinoplasty, or secondary rhinoplasty, is performed after an earlier facial plastic procedure produced subpar results, or if there was additional damage to the nose during or after the procedure.
An inexperienced plastic surgeon may unintentionally create unwanted changes or unpredictable courses of healing can occasionally lead to the development of visible scar tissue. The anatomy of the nose is very intricate, and since cartilage does not house any blood supply, the healing times are extended beyond most other cosmetic surgeries.
After experiencing poor results, patients may choose to request a revision rhinoplasty, often from a second doctor with more experience in this complex procedure.
Many times, Dr. Panossian will use an open rhinoplasty technique to reshape the nose in these cases and may even require cartilage grafts. Patients come from various parts of the world to have Dr. Panossian perform these difficult cases.
Revision Rhinoplasty Before-and-After Pictures
Patient Example #3: This patient has a history of cleft lip and palate nose deformity. She was unhappy with two previous rhinoplasty efforts. She underwent an extensive revision rhinoplasty using an open technique to reshape the tip of her nose and remove her bulbosity. In addition, the tip was lengthened slightly to give better proportion to the entire nose. Sometimes, due to depletion of cartilage inside the nose, a rib cartilage graft must be used as in this case.
Patient Example #4: This patient underwent closed rhinoplasty to straighten the nose, reduce the dorsal hump, correct the septum, and slightly refine the tip. The result was improvement of nasal shape and symmetry without losing his masculine appearance. This is the importance of male rhinoplasty. Incisions were placed inside the nose (endonasal rhinoplasty), leaving no visible scarring.
Why Would I Want a Rhinoplasty?
Patients who seek out a nose job in the Los Angeles area with plastic surgeon Dr. Passonian often feel that the appearance of their nose makes them look less attractive. In the areas near Pasadena, CA, rhinoplasty is common due to the influence of the entertainment industry. Nose surgery is often performed to boost a person’s image or to make them appear a certain way on screen.
Some people describe wanting to hide their face or avoiding mirrors due to their looks, while others seek more subtle improvements. Nasal disfigurement caused by a disease or traumatic incident can affect a person’s appearance and serve as a negative reminder of the event. Rhinoplasty can help patients improve their confidence, facial balance, and sometimes, correct breathing problems.
Am I a Candidate for Rhinoplasty in Pasadena?
Ideal candidates for a rhinoplasty procedure will be able to answer “yes” to the following questions:
- Do I think a more attractive nose would improve my self-esteem?
- Am I physically and mentally healthy enough to undergo the surgery?
- Do I have realistic expectations of the changes that can be achieved?
The doctor reviews each person’s candidacy on a case by case basis. Pregnant women, those battling cancer or another serious health condition, and people with active infections may need to postpone rhinoplasty. It is rare, however, that a person is permanently ineligible for a Pasadena rhinoplasty.
What to Expect at a Rhinoplasty Consultation
Prospective patients are encouraged to schedule a consultation with Dr. Panossian to discuss their desire for a nose job in Los Angeles at Andre Panossian MD Plastic Surgery, conveniently located in north-central LA.
The doctor will review the patient’s paperwork to determine if he or she is healthy enough for the procedure. He will then go over the patient’s aesthetic goals and make treatment recommendations. In some cases, Dr. Panossian may recommend alternate procedures, or suggest additional surgeries or treatments based on the patient’s aesthetic preferences and individual anatomy.
Dr. Panossian can create a preliminary treatment plan and describe the two main rhinoplasty techniques: open rhinoplasty and closed rhinoplasty. Open rhinoplasty requires an incision in the columella, which is the exterior skin that divides the two nostrils. It can result in a small but hidden scar.
In a closed rhinoplasty, the doctor accesses the cartilage and bone internally through the nostrils and incisions made inside the nose. The patient’s goals and nasal structure can help Dr. Panossian determine which technique to recommend.
How to Prepare for Rhinoplasty Surgery
Before patients can undergo a rhinoplasty procedure in Pasadena, they must follow Dr. Panossian’s pre-surgical preparation steps. He may require imaging of the sinuses, records, and approval from the patient’s primary care physician, and/or request lab work. Patient safety is of primary concern during an elective procedure.
Rhinoplasty patients should also fill any prescriptions written for the surgery in advance. After surgery, Dr. Panossian might request that patients take medications to control inflammation and swelling, infection, and to mitigate any post-surgical discomfort.
Hand sanitizer should be purchased to help the patient keep their hands clean while resting after surgery. Straws are also a good item to purchase because drink glasses and containers can bump the nose, and tilting the head backward can cause fluid to drain down the throat.
Because patients will have some downtime after surgery, they should take at least a week off from their regular schedules and prepare their recovery area in advance. Clean bedding and clothing, along with adequate pillows for keeping the head elevated can be prepared in the days leading up to the surgery.
Whether a patient is local or travels to Pasadena to undergo a rhinoplasty, he or she should arrange for a ride to and from the surgery, and schedule a home caretaker for the first postsurgical 12 hours. Preparing meals in advance will ensure the patient has healthy food available throughout the recovery period.
Patients should discontinue or decrease the dosage of certain medications, as instructed by Dr. Panossian, and should not eat for at least 12 hours prior to the rhinoplasty. They should shower the day of the surgery, and may be provided with a special antimicrobial soap to use on their skin. Appointment-day attire should include a loose top that can be easily zipped or buttoned on and off to avoid impacting the nose.
The Rhinoplasty Surgery
Rhinoplasty is performed at an accredited surgical center in Pasadena. The details and techniques to be used will be determined prior to the surgery date. Dr. Panossian meets with patients before the surgery to discuss their desired changes and explain his approach. He may use a surgical marker to create a plan to follow once the surgery begins.
Patients will also meet other members of the surgical team which might include an anesthesiologist and specialty nurses. Once Dr. Panossian and his team are ready to begin, the patient will be anesthetized in a comfortable sleep for the duration of the rhinoplasty procedure.
Recovering from a Rhinoplasty
The day of the surgery, patients are discharged once the anesthesia is reversed and they are fully awake. They must have a ride take them home or to their hotel room to recover. They may feel groggy for the next 24 hours. When sleeping, postoperative rhinoplasty patients are asked to use pillows to prop themselves up to a 45-degree angle so gravity can help control nasal swelling in the first week.
Patients should take a week off work or other regular activities, and should not exercise or do other activities that raise their heart rate for 6 weeks. Most patients do not need pain medication or other comfort measures like a cold compress beyond the first week. The nose will change most dramatically during this time.
There are also some special considerations that may apply to patients. After surgery, wearing glasses is discouraged. They may need to be taped up on the forehead with medical tape or otherwise held away from the bridge of the nose.
Nerves are temporarily affected and may cause an itching sensation in the nose. Patients should not scratch the nose to avoid affecting the still malleable structure or sutures, but may be able to use a cotton swab instead. Because patients must refrain from blowing their or sniffling for one week, tissues for any fluid drips are good to keep nearby.
At the end of the initial healing period, patients will need to return to Dr. Panossian’s office for a routine post-procedural checkup and to have their nasal packing, cast, or sutures removed. Depending on when the postsurgical rhinoplasty appointment is scheduled, patients may require transportation to Dr. Panossian’s Pasadena, CA office.
Though the majority of the swelling and bruising will subside in a week or two, it can be a full 18 months until the final results of the nose surgery are visible. The extended healing period is the result of limited blood flow to the area and the intricate structures of the nose. The nasal bones, along with the cartilage, are the major supports of the nose and will determine its final form.
The following is a set of instructions given to Dr. Panossian’s patients after rhinoplasty. They may be modified as needed for each patient by Dr. Panossian, if necessary.
Your splints and sutures will be removed in the office by Dr. Panossian.
- Irrigate the nose with a salt water spray (also known as Ocean Spray, available over-the-counter at any pharmacy). Apply Vaseline or Aquaphor inside the nose at night for two weeks using Q-tips or a thinly rolled tissue. Use a mirror to monitor how you do this to avoid excessive pressure. Sutures, mucous, and dried blood will come out, which will help you breathe better.
- Tape your nose only at night. Although taping will not affect the final result, it will help minimize swelling that develops overnight during the early postoperative period.
- Avoid alcohol and blood thinners (aspirin, motrin, advil, excedrin, naproxen, ibuprofen, vitamin E, fish oil, omega 3 fatty acids, herbal supplements ) for 2 weeks after surgery.
- Showers, make up, facial creams can be restarted.
Potential Risks and Side Effects of Rhinoplasty
job surgery should be performed by an experienced, board-certified surgeon to
avoid complications. Risks can be minimized, but not fully eliminated, due to
varying circumstances. Risks may include:
- Bruising and swelling
- Tingling sensations
- Pain and discomfort
- Nasal congestion
- An undesirable outcome
- Permanent tissue damage
- Need for revision rhinoplasty
Why Should Dr. Panossian Perform My Rhinoplasty?
Pasadena rhinoplasty is performed by renowned board-certified plastic surgeon Dr. Andre Panossian, who is known internationally for his work. Having trained both in the United States and France, the plastic surgery expert is uniquely qualified and is skilled in advanced concepts practiced in Europe.
I am eternally grateful for Dr. Panossian and the amazing work that he does. I was born with a unilateral cleft lip & palate and have undergone 4 surgeries related to my deformity. I was looking for a revision rhinoplasty surgery, unhappy with the asymmetric appearance of my nose, due to my cleft. There were also some minor breathing issues and constant sinus problems, too. After intensive research looking for a competent doctor that could help my complicated case, Dr. Panossian was my top choice. Even in my first consultation, Dr. Panossian took his time explaining the possible procedure. He has a great bedside manner, doesn’t talk down to you, helps to educate you, and ultimately wants the best for you as a patient. I knew he was the right person to do this surgery so we scheduled my major cleft revision rhinoplasty, septoplasty with rib grafting, turbinoplasty, and osteotomy.
There was one point where my insurance had changed their mind and denied covering my surgery, claiming it was not medically necessary. Like I chose to be born with a deformity. Dr. Panossian and his staff would not take no for an answer. They fought for me, tooth and nail, to get my surgery covered. As a patient, this seriously meant the world to me. Dr. P scheduled a meeting with my insurance and explained why this was medically necessary for me to receive. He really went above and beyond to get this done for me. A special shoutout to office staff Amber, she has been extremely kind, patient, and thorough throughout this entire process.
My surgery was about 6 hours long and went without a hitch. Dr. Panossian did a fantastic job and I am now 2 1/2 weeks post-op. Things are healing well and I’m impressed with the work he has done. I am looking forward to being able to breathe fully and properly, and not look in the mirror and see my defect. THANK YOU, Dr. Panossian, from the bottom of my heart.
Frequently Asked Questions About Rhinoplasty
Rhinoplasty is a cosmetic surgery that is performed to improve the overall appearance of the nose. A patient may choose a nose job in Pasadena because they feel that their nose has an undesirable size and shape or does not harmonize with their other facial features.
Facial rejuvenation, on the other hand, is typically performed to correct signs of aging like lines, wrinkles, and skin laxity. The nasal tip can also appear droopy as we age and in these cases, rhinoplasty may be incorporated into a facial rejuvenation treatment plan.
Dr. Panossian will inform patients of any known limitations of their planned rhinoplasty. To help patients visualize how they may appear after the surgery, he can use imaging software, provide results from former patients, and explain how each part of the nose can be altered. Results may not be exact, but plastic surgery is a fine-tuned hybrid of science and art, and Dr. Panossian is able to meld the two to achieve a very attractive nose for each patient.
While it is normal to experience some discomfort following surgery and during the early phase of the healing process, patients can take many steps to mitigate pain. Medications that help control swelling, infection, and pain may be administered during the procedure or prescribed before the rhinoplasty surgery date.
Patients are encouraged to gently apply a cold compress as needed, to lie down with their head elevated, and to avoid looking down and bending over for the first week to help relieve any pressure and to better manage pain. Pain tolerance varies from one patient to the next, but the operation is generally tolerated very well.
Primary rhinoplasty patients must wait at least 6 months before undergoing a secondary rhinoplasty. This allows Dr. Panossian to view the mostly-healed tissues and determine how he can improve the look or functionality of the nose. In some cases, patients may be asked to wait an entire year before undergoing a second procedure, though the lengthy wait is less common and typically reserved for more complex cases.
This article was written by Dr. Andre Panossian, MD